Squamous cell carcinoma in discoid lupus erythematosus: Reconstruction with a free forearm fasciocutaneous flap

Kesiktaş, Erol; Yavuz, Metin; Gencel, Eyüphan; Kesiktas, Naile Nüket

doi:10.1080/02844310601159881

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…There are not many reports regarding free tissue transfers in patients with autoimmune diseases under immunosuppression, but most that there are emphasize the fact that if performed carefully tissue transfer is very feasible. 3,4,6,7,[9][10][11][12][13][14][15] We agree, and believe that free tissue transfer should not be avoided where needed. However, we would also emphasize the high probability of free flap complications.…”

Section: Discussionmentioning

confidence: 75%

Perforator Free Flap Coverage of Chronic Lower Extremity Ulcers in Patients With Autoimmune Diseases Under Immunosuppression

Kim

2020

The International Journal of Lower Extremity Wounds

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Objectives. Lower extremity ulcers are quite common in patients with autoimmune diseases. Due to chronic use of immunosuppressants, these wounds may develop into deeper wounds resulting in exposure of bone or tendon, which in turn may require free tissue transfers for coverage. The author reviewed perforator free flap transfers performed in this group of patients and analyzed the results. Methods. A retrospective review was performed on all patients who underwent perforator free flap transfer for coverage of lower extremity ulcers without trauma, over a 10-year period. Patient demographics, administered immunosuppressants, and flap and donor site complications were analyzed. Results. Twenty-two perforator free flap transfers were performed in patients with autoimmune diseases, including 18 thoracodorsal perforator flaps, 2 anterolateral thigh flaps, and 2 deep inferior epigastric artery flaps. There was no total flap loss, but there was a high rate of partial flap necrosis (40.9%) and wound dehiscence (40.9%). Intake of corticosteroids was significantly associated with postoperative complications ( P < .05). Conclusion. As partial loss of flap and wound dehiscence is much more common in this group of patients, treatment may take longer, and a fully informed consent should be obtained preoperatively. Surgeons should not avoid performing perforator free flap transfers in patients with autoimmune diseases under immunosuppression; instead, much more preparation and caution are required.

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Section: Discussionmentioning

confidence: 75%

Perforator Free Flap Coverage of Chronic Lower Extremity Ulcers in Patients With Autoimmune Diseases Under Immunosuppression

Kim

2020

The International Journal of Lower Extremity Wounds

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“…Photodynamic therapy, interferonalpha, retinoids, 5-fluorouracil and topical imiquimod have also been used, with varying success. 7,8 Keratoacanthoma, presenting as a hyperkeratotic nodule with central adherent crust, has also been reported overlying DLE plaques. 4,5,9 However, keratoacanthoma is much rarer as compared to SCC.…”

Section: Discussionmentioning

confidence: 99%

“…Photodynamic therapy, interferon-alpha, retinoids, 5-fluorouracil and topical imiquimod have also been used, with varying success. 7,8…”

Section: Discussionmentioning

confidence: 99%

Neglect leads to extremes: maggots and malignancy in a case of discoid lupus erythematosus

Bhari

Khaitan

Gupta

et al. 2015

Lupus

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Discoid lupus erythematosus (DLE) is a chronic form of cutaneous lupus erythematosus that runs an indolent course. The rare complications of DLE include scarring, mutilation, non-healing ulceration, cicatricial alopecia and malignancy. DLE progresses to systemic lupus erythematosus (SLE) in around 5% of localized cases and 22% of generalized cases. We report a case of DLE, presenting with a six-month history of ulcerated fungating plaques and small crusted nodules superimposed on DLE plaques over both the forearms. Two weeks prior to the presentation, maggots were also noticed on these plaques. Skin biopsies from these lesions were suggestive of squamous cell carcinoma (SCC) and keratoacanthoma. A wide surgical excision of the tumor followed by partial split-thickness skin grafting was performed with complete healing of the lesions. No recurrence has been noted 18 months from follow-up.

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“…1 Less commonly, venous and decubitus ulcers, vaccination scars, chronic osteomyelitis, 1 hidradenitis suppurativa, pilonidal cyst and discoid lupus erythematosus may be involved. 3 Osteomyelitis is a well-known precursor of squamous-cell carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Úlcera de Marjolin associada a ulceração e osteomielite crônicas

Tavares

Martinho

Dores

et al. 2011

An. Bras. Dermatol.

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This report describes a 78-year old male patient with a chronic venous ulcer on his left leg for the past 24 years, complicated by a squamous-cell carcinoma. After staging of the disease, the treatment administered was amputation of the leg above the knee. Marjolin's ulcer consists of the malignant transformation of a chronic ulcerative lesion. It is a relatively rare phenomenon. The malignant tumor most commonly described in the literature is squamous cell carcinoma, followed by basal-cell carcinoma, sarcoma and melanoma. The pathogenesis of Marjolin's ulcer remains to be fully clarified. Keywords: Carcinoma, squamous cell; Leg ulcer; Osteomyelitis Resumo: Doente do sexo masculino, de 78 anos, portador de uma úlcera venosa crônica na perna esquerda, com cerca de 24 anos de evolução, complicada por carcinoma espinocelular. Após o estadiamento da doença, o tratamento preconizado foi amputação acima do joelho esquerdo. A úlcera de Marjolin é a transformação maligna de uma lesão ulcerosa crônica. Trata-se de um fenômeno relativamente raro. A neoplasia maligna mais frequentemente descrita na literatura é o carcinoma espinocelular, seguido do basalioma, sarcoma e melanoma. A sua patogenia permanece pouco compreendida.

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Squamous cell carcinoma in discoid lupus erythematosus: Reconstruction with a free forearm fasciocutaneous flap

Abstract: We present the first free flap operation to our knowledge for a patient with squamous cell carcinoma on a lesion of discoid lupus erythematosus. Although the disease affects the skin, the defect was reconstructed successfully with a free radial forearm fasciocutaneous flap.

Cited by 4 publications

References 8 publications

Perforator Free Flap Coverage of Chronic Lower Extremity Ulcers in Patients With Autoimmune Diseases Under Immunosuppression

Perforator Free Flap Coverage of Chronic Lower Extremity Ulcers in Patients With Autoimmune Diseases Under Immunosuppression

Neglect leads to extremes: maggots and malignancy in a case of discoid lupus erythematosus

Úlcera de Marjolin associada a ulceração e osteomielite crônicas

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